600例初产妇不同分娩方式产后早期盆底功能检测的临床研究  

Clinical study on detection of pelvic floor function during early postpartum period in 600 primiparas with different delivery methods

作　　者：魏琳娜[1] 徐玉婵 李瑶 余友霞[2] 周玮[1] WEI Linna;XU Yuchan;LI Yao;YU Youxia;ZHOU Wei(Department of Obstetrics,Chongqing Municipal Maternal and Child Health Care Hospital,Chongqing 401120,China;Department of Nursing,Chongqing Municipal Maternal and Child Health Care Hospital,Chongqing 401120,China)

机构地区：[1]重庆市妇幼保健院产科,401120 [2]重庆市妇幼保健院护理部,401120

出　　处：《重庆医学》2020年第24期4066-4069,4074,共5页Chongqing medicine

基　　金：重庆市科技局创新与应用发展面上资助项目(csct2019jscx-msxmX0209);重庆市渝中区科技计划资助项目(20170415)。

摘　　要：目的比较不同分娩方式对初产妇早期盆底功能的影响。方法选择2018年6月至2019年6月在该院分娩的600例初产妇为研究对象,其中剖宫产分娩300例(剖宫产组),阴道分娩300例(阴道分娩组),分析两种分娩方式的早期盆底功能障碍情况。结果阴道分娩组中阴道前壁膨出、阴道后壁膨出及子宫脱垂率均高于剖宫产组,差异有统计学意义(P<0.05);阴道分娩组盆底深层肌与浅层肌肌力受损率均高于剖宫产组,差异有统计学意义(P<0.05);两组产后尿失禁、尿频、尿急、下腹酸胀、下坠感等临床症状发生率比较,差异均无统计学意义(P>0.05);产后42 d剖宫产组盆底表面肌电后静息过度活跃占比高于阴道分娩组(P<0.05),而阴道分娩组60 s持续收缩阶段慢肌耐力异常率高于剖宫产组(P<0.05),两组盆底表面肌电前静息阶段过度活动占比和快肌、慢肌肌力异常率之间差异无统计学意义(P>0.05),另外剖宫产组盆底肌前、后静息肌电值均高于阴道分娩组(P<0.05),剖宫产组慢肌肌力和耐力均高于阴道分娩组(P<0.05),两组快肌肌力之间差异无统计学意义(P>0.05)。结论规范的产后盆底筛查有利于盆底功能康复。Objective To compare the effects of different delivery modes on early pelvic floor function of primiparas.Methods Six hundreds primiparas delivered in this hospital from June 2018 to June 2019 were selected as the study subjects,including 300 cases of cesarean section(cesarean section group)and 300 cases of vaginal delivery(vaginal delivery group).The early pelvic floor dysfunction situations were compared between the two groups.Results The incidence rates of anterior vaginal wall prolapse,posterior vaginal wall prolapse and uterine prolapse in the vaginal delivery group were higher than those in the cesarean section group,and the differences were statistically significant(P<0.05);the myodynamia injury rates of deep and superficial muscles in the vaginal delivery group were higher than those in the cesarean section group,and the differences were statistically significant(P<0.05);the incidence rates of postpartum urinary incontinence,frequent and urgent micturition,lower abdominal swelling and tenesmus feeling between the two groups showed no statistically significant difference(P>0.05);the proportion of resting hyperactivity after pelvic floor electromyography an postpartum 42 d in the cesarean section group was higher than that in the vaginal delivery group(P<0.05).However,the abnormal rate of slow muscle endurance during the 60 s continuous contraction phase in the vaginal delivery group was higher than that in the cesarean section group(P<0.05).There was no statistically significant difference in the proportion of excessive activity before resting stage of pelvic floor surface myoelectricity and abnormal rate of fast muscle and slow muscle strength between the two groups(P>0.05).In addition,the anterior and posterior resting myoelectric values in the cesarean section group were higher than those in the vaginal delivery group(P<0.05),and the slow muscle forces and endurance in the cesarean section group were higher than those in the vaginal delivery group(P<0.05).There was no statistically significant differenc

关 键 词：阴道分娩 剖宫产 初产妇 盆底功能障碍 生活质量 

分 类 号：R714[医药卫生—妇产科学]